A Critical Analysis of Immigrant Children and Adolescents in U.S. Professional Counseling Literature

ABSTRACT

In this content analysis, we examined 20 years of peer-reviewed counseling research with immigrant children and adolescents published between 2002–2022. We conducted a comprehensive analysis that included a total of 32 articles from American Counseling Association (ACA) and ACA division journals. We analyzed the articles and identified five overarching themes that shed light on the publication trends and existing gaps in the literature concerning issues of immigrant children and adolescents. Recommendations are presented and discussed for advancing future practice and research in the counseling field.

KEYWORDS:

• immigrant
• children
• adolescents
• counseling
• content analysis
• foreign-born

The United States Census Bureau designates immigrants as any individual who identifies as foreign-born, which can include individuals who hold visas, are seeking asylum, refugees, and undocumented individuals. Currently, the immigration population in the United States is the highest ever recorded (American Immigration Council, 2021). The Census Bureau’s monthly Current Population Survey (CPS) indicates more than 46 million immigrants currently reside in the United States, making up 14.2% of the nation’s population (American Immigration Council, 2021). The immigrant population in 2019 includes 20.4 million men, 22.0 million women, and 2.5 million children (Budiman et al., 2020). Immigrant children are one of the fastest growing child populations in the U.S., with 38.3 million children being born in the United States (US) with at least one immigrant parent, comprising 12% of the total population in the United States (American Immigration Council, 2021). While the range is quite large, between 7.0 to 22.0% of documented or undocumented immigrant children living in the United States arrived during childhood, demonstrating the large number of children with vast cultural and immigration experiences (American Immigration Council, 2021).

For this article, we use the term immigrant children to refer to children and adolescents from birth to age eighteen who were born outside of the U.S. or have at least one foreign-born parent, regardless of current immigration status. Recognizing that an immigrant child can come to the U.S. during childhood or be born in the U.S., as well as the multiple contextual factors associated with one’s birthplace (e.g., familial, social, cultural, and political situations), we also distinguish children who are either first or second-generation immigrants. First generation immigrant children refer to those who were born in another country and who gained citizenship or permanent residency in the U.S., and second generation refers to children born in the U.S. to at least one immigrant parent (Attia et al., 2023).

Adjustment experiences

Immigrant children in the U.S. experience unique challenges. Upon arrival in the US, immigrants must adapt to a different culture, new roles, new environment, as well as a new linguistic reality, during which many individuals experience stressors and difficulties from the process of acculturation (Dimitrova et al., 2016; Zlobina et al., 2006). Indeed, the negative impact of acculturative stressors on immigrant children’s psychological well-being is well-documented in existing literature. Researchers identified multiple factors that contribute to acculturative stress, including pre-migration traumatic conditions, early family separations, and whether one enters the U.S. with legal documentation (Balls Organista et al., 2003; Suárez-Orozco, 2001). Further, a new host of stressors often emerge post-migration to create socio-cultural barriers to immigrant children’s healthy and successful adaptation to the new societal or school environment. Due to prevailing racism and other anti-immigrant attitudes, immigrants may encounter various forms and degrees of stereotypes, discrimination, prejudice, and social exclusion increasing risks to mental health and healthy development (Omidvar & Richmond, 2003; Szalacha et al., 2003). Cronholm et al. (2015) identified discrimination and bullying, often encountered by immigrant children, as Adverse Childhood Experiences, linked to multiple physical and mental health risks including depression, anxiety, suicidality, heart disease, and diabetes. These experiences place immigrant children in the U.S. at risk for significant health and mental health issues into adulthood, as well as social difficulties such as not graduating from high school, unemployment, and increased rates of incarceration (Cronholm et al., 2015).

As immigrant children enter the U.S. educational system, they encounter a new culture. Schools, as the host of mainstream social norms and cultural values, are the major ecological context in which the adaptation and acculturation processes occur for immigrant children (Kim, 2007). At school, newcomer immigrant youth often are confronted with not only the usual academic stress, but also additional challenges of resettlement, social integration, and other issues related to the developmental trajectory itself. Immigrant students experience multiple challenges within the school system, including language barriers (Koelsch, 2006), acculturation difficulties (Gil & Vega, 1996; Smokowski & Bacallao, 2009), and discrimination (Smokowski & Bacallao, 2007), which impact the educational experiences of immigrant students. Additionally, the immigrant involvement in the school systems influences parent-child relationships, mental health, career, and academic needs of immigrant students (Chung, 2010; Nieri, 2012).

Specifically, immigrant students, despite English Language programs in schools, often experience difficulty adjusting to and learning a new language not shared by their families (Bowman-Perrott et al., 2010; Chung, 2010; Derderian-Aghajanian & Wang, 2012), as well as difficulties adjusting to the learning domain of everyday school life (Bowman-Perrott et al., 2010; Smokowski & Bacallao, 2009; Vela-Gude et al., 2009). Many immigrant students with visible minority status reported experiencing unfair treatment from teachers due to racial and linguistic differences, as well as social isolation from their English-speaking peers, hindering their psychosocial and academic functioning (Messinger et al., 2012; Smokowski et al., 2014; Vela-Gude et al., 2009).

In addition to acculturation difficulties experienced within the school systems, immigrant children often experience intergenerational and family conflict as they begin to navigate two cultural experiences (Lui, 2015; Titzmann & Sonnenberg, 2016). Children acculturate to the American culture through the educational system, often more rapidly than their immigrant parents (Liu, 2015; Portes & Rumbaut, 2006). As a result, intergenerational conflict can occur as discrepancies between cultural norms, values, and behaviors arise between caregivers and children (Chang et al., 2013; Villatoro et al., 2014). These interfamilial acculturation difficulties can impact children’s mental health and increase behavioral difficulties in immigrant children (Lau et al., 2011; Rogers-Sirin et al., 2013).

Mental health needs and service

Migration and the subsequent cultural adjustment experiences can play a vital role in shaping a child’s mental health, development outcomes, as well as resettlement in a new culture, environment, and social role (Dimitrova et al., 2016). Most studies focusing on post-migration experiences of immigrant children found increased exposure to multiple risk factors including poor schools, neighborhood violence, discrimination, poverty, as well as disparities in health, mental health, education, and employment access and outcomes (Perreira & Ornelas, 2011; Pong & Landale, 2012). These risk factors, both independently and jointly, heighten the potential vulnerability of immigrant children and are associated with a range of negative academic, developmental, and mental health outcomes, such as poor school performance, psychosocial adaptation, and high prevalence of psychological disorders (Cronholm et al., 2015). Researchers found that 19.3 to 28.5% of immigrant children reported a mental health condition; however, only about 7.7 to 23.1% of those children sought and received psychosocial services for their mental health problems (Toppelberg et al., 2013).

Specifically, migration-related stress and trauma, as well as exposures to violence in neighborhood, community, family, or school, are associated with the development of post-traumatic stress and anxiety symptoms among immigrant children (Jaycox et al., 2002). Depressive symptoms were also constantly and consistently reported in the literature that characterize 6.8% to 28.8% of immigrant children in the U.S (Jaycox et al., 2002; Potochnick & Perreira, 2010). Poor mental health is often associated with suicidal ideation and attempts among immigrant children. Previous researchers report that multiple intersecting factors influence differential vulnerabilities in the risk of suicide ideation among immigrant children, including the child’s age of migration, gender, and nativity (Cho & Haslam, 2010; Van Leeuwen et al., 2010). For example, what we know well about the risk of suicidality among immigrant children is that this risk has been astonishingly high among Latina girls, presenting the highest prevalence of suicidality indicators (Szlyk et al., 2019; Zayas et al., 2005). Early exposures to neglect, abuse, or violence also put immigrant children at risk for developmental disorders, autism, substance abuse, and conduct disorders (Fontes, 2002; Toppelberg et al., 2013).

Barriers to seeking services

In general, immigrant populations often have difficulty utilizing public services while having even greater challenges accessing mental health services. Earlier researchers suggested that factors contributing to the limited access to and utilization of mental health services include communication difficulties between mental health professionals and immigrant families, as well as the different priorities and expectations that immigrant families have compared to professionals (Gupta, 1991; Storch & Poustka, 2000). More recent researchers indicated that language barriers are likely to hinder the utilization of mental health services among immigrant children (Javier et al., 2010; Pumariega & Rothe, 2010). A lack of health insurance coverage may also play a role in the likelihood of seeking and using mental health services among these populations (Carson et al., 2011).

Further, in fear of deportation or other undesirable legal or residential consequences, many undocumented children or U.S. born children with undocumented family members or parents may choose not to enroll in Medicaid or similar health insurance (Castaneda & Melo, 2014), potentially contributing to the underutilization of mental health services. Cultural factors, such as race and ethnicity, may also shape their likelihood of using services. For example, researchers indicated that Haitian and Caribbean Black immigrant children were less likely to be involved in any type of mental health services relative to immigrant children from other ethnic or racial groups (Assari & Caldwell, 2017; Carson et al., 2011). Mixed results were concluded on age as a sociodemographic factor, with one study indicating that younger children were less likely to use mental health services than older ones among immigrant populations (Toppelberg et al., 2013), whereas other studies observed no difference between different age groups.

Need for the study

The rapidly changing demographics in classrooms and communities across the United States have prompted multiple calls for initiatives aiming at better preparing counselors, teachers, schools, and other stakeholders to work effectively with immigrant children and families. Professional counselors, as agents of social change with a focus on development, social justice, advocacy, and empowerment, are in the best and most critical position to address the distinct needs of immigrant youth in school and community settings (Stewart, 2014). Counselors are the helping professionals on the front lines of supporting immigrant children’s academic, social, emotional, and career development while also addressing the need for bridging mental health disparities and achievement gaps rooted in societal inequities (Goh et al., 2007). Further, counselor educators hold leading positions in driving research initiatives to enhance our understanding of issues facing immigrant children, recommend and promote best practices, and develop modalities to ensure culturally competent services for immigrant children and families (Crawford et al., 2019). Despite the calls for counselors to be active leaders in promoting transformations in current systems, the issues facing immigrant children and their families remain largely understudied in the existing counseling literature. Accordingly, the purpose of this content analysis is to conduct a comprehensive examination of the counseling literature that focused on immigrant children and adolescents from 2002 to 2022.

Method

To develop a comprehensive, in-depth understanding of adjustment and mental health issues around immigrant children and adolescents, we conducted a qualitative content analysis. By following a multi-stepped, systematic classification process, qualitative content analyses have been used as a methodology throughout the counseling literature to make valid inferences from the content of text data; to identify themes or patterns; to describe publication trends; and to reveal the focus within a particular publication period (Attia et al., 2021; Clark et al., 2018; Evans, 2013). Guided by the research question, “What are the publication trends in ACA and ACA Division journals from 2002–2022 on immigrant issues among children and adolescents in counseling?,” this content analysis aimed to provide a thorough investigation of the counseling journals, particularly publishing articles on issues related to immigrant children and adolescents.

Research bias statement

Recognizing and addressing researcher bias is crucial for determining the accuracy of data interpretation and analysis in qualitative research (Rolfe, 2006). As such, the establishment and maintenance of trustworthiness is considered the first step in qualitative data analysis for bolstering rigor in the inquiries (Creswell, 2013). Therefore, our research team developed protocols and strategies to ensure trustworthiness and minimize research bias through engaging in a series of reflexivity activities (Creswell, 2013). The research team members conducted team discussions focused on the reflections of previous experiences with immigrant children and families, as well as any potential biases that would interfere with data interpretation. Each team member also took a reflexive stance to bracket and self-reflect on their personal background, assumptions, beliefs, worldviews, preconceived knowledge, experiences, and overall biases that would arise before and during the analytical process.

Research team

The research team included two counselor educators, two counseling doctoral students, and one counseling masters student. The primary researcher is a counselor educator at a large research-intensive institution, an immigrant and person of color, who organized the project and set the parameters for the literature search. Researcher two is also an Assistant Professor at a large research-intensive institution, identifies as White and served as an internal auditor. Researcher 3 is a doctoral-level research assistant, a counselor-in-training of Asian heritage and woman of color, who had extensive training and experience in conducting content analysis, qualitative data analysis, and coding. Researcher 4 is a masters-level counseling student who identifies as a white, cis-gender woman who was born and raised in the United States. Researcher 5 is a doctoral-level counseling student who self-identifies as an East Asian, cis-gender male. He is also an international student and has been involved in extensive graduate research work since he moved to the US. As part of the analytical procedure, each member of the research team independently reviewed the identified articles and performed coding. The team came together weekly to communicate about the project, discuss similarities and differences in coding, and resolve disagreements to come to a consensus on selected articles and themes.

Procedure

Krippendorf’s four procedures (2013) for content analysis informed and guided the present investigation, progressing from selecting units to processes of sampling, recording, and reducing. In the present content analysis, the unit of analysis referred to each individual article sample that addressed issues around immigrant children in counseling journals. Second, research team members began with the sampling process (Krippendorff, 2013) and thus created a list of top-tier counseling journals from the ACA website (www.counseling.org). A total of 23 major journals were selected for review: Adultspan, Career Development Quarterly, Counseling and Values (CVJ), Counselor Education & Supervision (CES), Counseling Outcome and Research Evaluation, Journal of Addictions & Offender Counseling (JAOC), Journal of Child and Adolescent Counseling (JCAC), Journal of College Counseling (JCC), Journal of Counseling and Development (JCD), Journal of Counselor Leadership and Advocacy (JCLA), Journal of Creativity in Mental Health, Journal of Employment Counseling (JEC), Journal of Humanistic Counseling (JHC), Journal of LGBT Issues in Counseling, Journal of Mental Health Counseling (JMHC), Journal of Military and Government Counseling, Journal of Multicultural Counseling and Development (JMCD), Journal for Social Action in Counseling and Psychology (CSJ), Journal for Specialists in Group Work (JSGW), Measurement and Evaluation in Counseling and Development, Rehabilitation Counseling Bulletin, Professional School Counselor, and The Family Journal (TFJ).

Continuing with the sampling process, the authors conducted a search and review of all empirical studies on the EBSCOhost database using the following keywords: immigrant, refugee, alien, fugitive, displaced person, emigrant, or exile AND children, adolescents, teenager, youth, offspring, or students. With the aim to locate all available units of analysis, the authors conducted a second-round article search to identify articles through each journal’s online publishing database. For example, we examined the Journal of Counseling and Development published by Wiley Online Library through their journal website (https://onlinelibrary.wiley.com/journal/15566676). The authors reviewed each article and selected articles that met the inclusion criteria of this analysis that not only included the keywords in the title, abstract, and content but 50% or more of the content of the article were directly related to immigrant children. As such, we excluded articles if the content were not related to immigrant children or lacked detailed attention to relevant issues, despite containing relevant keywords. The search yielded a total of 32 articles from 12 counseling journals from 2002–2022 (Table 1). We analyzed each article and identified a total of five themes.

Table 1. ACA articles found by journal and research methodology between 2002–2022.

		Research Methodology
Journal	Total	Qualitative	Quantitative	Mixed	Conceptual
Career Development Quarterly	3	1	1	0	1
Journal of Child and Adolescent Counseling (JCAC)	1	0	0	0	1
Counseling and Values (CVJ)	1	1	0	0	0
Journal of Counseling & Development (JCD)	5	3	1	0	1
Journal of College Counseling (JCC)	2	0	1	0	1
Journal of Multicultural Counseling and Development (JMCD)	7	3	2	0	2
Journal for Social Action in Counseling and Psychology (CSJ)	1	0	1	0	0
Journal for Specialists in Group Work (JSGW)	3	0	0	0	3
Rehabilitation Counseling Bulletin	1	0	1	0	0
Professional School Counselor	3	0	0	0	3
The Family Journal (TFJ)	2	1	1	0	0
The Journal of Mental Health Counseling	3	0	1	0	2
Total	32	9	9	0	14

Results

Our 20-year content analysis of counseling literature on immigrant children yielded five overarching themes: (1) Youth Racial and Ethnic Identity, (2) Interventions, (3) Adjustment, (4) Mental Health Needs, and (5) Developing Multicultural Competence. Table 2 below presents the themes and topics discussed and each theme’s corresponding definition.

Table 2. Themes of immigrant children in counseling literature between 2002–2022.

Theme	Definition
Youth Racial and Ethnic Identity	Racial or ethnic identity of immigrant adolescents, including Chinese, Korean, Latino, Turkish, and African refugees.
Interventions	Interventions and/or activities addressing the gaps in access to support (e.g., academic, behavioral, and social-emotional) using multiple modalities including group counseling, career counseling, family counseling, school-targeted interventions, and conceptual/theoretical recommendations for immigrant youth.
Adjustment	The processes, conditions, and outcomes of the psychological and sociocultural adaptation by which immigrant adolescents and families change attitudes, behaviors, values, orientations, and beliefs required by the cross-cultural transitional needs and demands.
Mental Health Needs	Mental health considerations (needs, barriers to care, risks and protective factors) specific to resettled immigrant and refugee youth and their pre-, during and post-migration experiences.
Developing Multicultural Competence	Activities designed to assess and promote the development of multicultural competence of counselors and counselor trainees, through working with immigrant and refugee adolescents and families.

Theme 1: youth racial and ethnic identity

The literature emphasized the importance of racial and ethnic identity among immigrant youth, with five topics discussed within the theme focusing on specific populations: Chinese Immigrant Youth, Korean Immigrant Youth, Latino Immigrant Children and Adolescents, African Refugee Youth, and Turkish Immigrant Adolescents. Studies highlighted the unique cultural and contextual factors that shape the identity development of these groups, such as the significance of family structure, community support, and social networks in fostering a sense of belonging.

Theme 2: interventions

Five topics discussed within the theme emerged related to interventions for immigrant children: Group Intervention, Career Development, Conceptual and Theoretical Intervention, School Counseling Interventions, and Family Therapy. The literature indicated that culturally responsive interventions are more effective in promoting immigrant adolescents’ well-being and academic success. For example, group interventions improved social skills, coping strategies, and a sense of belonging among immigrant youth. Furthermore, career development interventions helped immigrant youth explore and understand their vocational interests and aspirations.

Theme 3: adjustment

In this theme, we identified six topics discussed concerning the adjustment of immigrant children: Acculturative Stress, Cultural Negotiation, Language Brokering, Identity Negotiation, Parentification, and Cultural Strengths and Assets. The literature highlighted the complexities and challenges associated with the acculturation process, such as balancing the need to maintain cultural traditions while adapting to the new host culture. Studies also emphasized the importance of recognizing and leveraging the cultural strengths and assets of immigrant children to promote resilience and well-being.

Theme 4: mental health needs

Two topics discussed within the theme emerged related to the unique mental health needs of immigrant children: Child Survivors of War and Traumatized Refugees and Asylum Seekers. The literature revealed that these populations face heightened levels of trauma exposure and related mental health challenges, such as post-traumatic stress disorder, depression, and anxiety. Moreover, studies underscored the necessity for trauma-informed care and mental health services tailored to the unique needs of these populations.

Theme 5: developing multicultural competence

In this theme, we identified two topics for developing multicultural competence among professionals working with immigrant populations: Working with Immigrant Youth and Working with Refugee Families and Youth. The literature stressed the importance of cultural competence, knowledge, and skills in effectively supporting immigrant youth and their families. Moreover, researchers emphasized the need for ongoing professional development and training to enhance clinicians’ multicultural competence.

In summary, our content analysis yielded five overarching themes reflecting the diverse experiences, challenges, and strengths of this population, as well as foci and gaps in the literature. These findings, which we discuss further below, provide a comprehensive picture of the trends of research in professional counseling, and illuminate the needs for further research in less-presented topics.

Discussion

Our analyses of 20 years (2002–2022) of scholarship revealed in-depth insights into the trends in counseling literature on acculturative and mental health issues in immigrant children and adolescents. The identified themes represented how peer-refereed publications have examined the mental health challenges confronted by immigrant children and adolescents and broadened the understanding of those challenges’ impact on the population.

Thematic content

Articles on the theme of Youth Racial and Ethnic Identity covered an extensive range of specific ethnic identities of immigrant adolescents, including Chinese, Korean, Latino, Turkish, and African refugees. With nine articles in our findings, we observed a focus on utilizing conceptual and theoretical interventions to help immigrant youth clients cope with acculturative and academic stress and foster a more positive outlook and self-concept. On the other hand, the Intervention theme included articles highlighting interventions addressing immigrant youth’s academic, developmental, and social-emotional needs. As delineated in our analysis, the intervention covers multiple modalities: group counseling, career counseling, family counseling, school-targeted interventions, and conceptual/theoretical recommendations for immigrant youth. We observed that the articles on the Adjustment theme strongly link to acculturative stress in school and social environment, language barrier, discrimination, and poverty confronted by immigrant youth. The articles discussing acculturation struggles of immigrant youth also yielded an understanding of its impact on the parent-child relationship and guided counselors to approach the affected intra- and inter-generational family dynamic (Chang et al., 2013; Villatoro et al., 2014).

Our findings concerning the Mental Health Needs theme suggested a whole gamut of needs of immigrant youth, including familial, educational, developmental, mental, occupational, and financial needs, as a result of acculturative distress. The theme also considers immigrant youth’s needs before, during, and after their migration. Although researchers have developed interventions to address the broad range of needs of immigrant youth (Edirmanasinghe et al., 2022; Sohtorik & McWilliams, 2011; Stebleton, 2007), scholarly efforts addressing risk/protective factors (Cronholm et al., 2015) and barriers to care (Carson et al., 2011; Castaneda & Melo, 2014; Gupta, 1991; Johnson et al., 2020; Pumariega & Rothe, 2010; Storch & Poustka, 2000) for immigrant youth may inform counselors of their practice. For the theme Developing Multicultural Competence, based on our observation, it is vital to assess and promote the development of multicultural competence of counselors working with immigrant youth to support their mental health and optimal development.

Methodological categories

Regarding methodological categories, conceptual articles (14 articles) are composed of the most frequently implemented research methodology in our review, followed by quantitative (nine articles) and qualitative (nine articles) methodology. Furthermore, we found the use of the conceptual methodology in multiple themes (e.g., Intervention and Developing Multicultural Competence). This finding suggested the popularity of literature adopting the conceptual research methodology over empirical studies. The findings warrant counseling scholars’ continuous effort in conducting empirically based research to study the mental health and development of immigrant youth and inform the gap between research and practice for counselors. Additionally, when it comes to data-driven research design, our analysis indicated that many articles on immigrant children and adolescents utilized quantitative and qualitative approaches, while no articles implemented mixed-methods designs. This finding may reveal counseling scholars’ preference for quantitative and qualitative over mixed methods designs. Finally, it is noteworthy that specific research design methods may lend themselves more than others to addressing the research questions in some areas of immigrant youth literature (Ceballos et al., 2023; Zyromski et al., 2023). This issue may warrant ongoing research efforts focusing on all the themes to tackle the domination of using particular methodologies. Our findings also revealed that the articles corresponding to themes, including Interventions, Adjustment, Mental Health Needs, and Developing Multicultural Competence, were primarily conceptual studies. For the theme of Youth Racial and Ethnic Identity, counseling scholars utilized qualitative and quantitative designs for publication. We provide a thorough discussion of future directions, particularly related to the gaps we found through this study, in the Future Research section.

Limitations

Despite the authors’ best efforts, this study is subject to certain limitations. One such limitation is our sample size. While we intentionally selected only 23 journals for review, a larger sample size may have provided access to additional articles and affected our results. There also appears to be a lack of previous research on this subject. Out of the 23 journals selected for review, only 12 journals published articles with keywords matching our search criteria. Another limitation is our use of only Counseling and ACA division journals. While this decision was intentional, we recognize that there are journals in other helping professions publishing on this topic, with researchers from the counseling profession. Additionally, it is a challenge to completely eliminate researcher bias from the present study (Rolfe, 2006). Despite our efforts to ensure trustworthiness via bracketing, self-reflection, and the use of an internal auditor (Creswell, 2013), a different group of researchers may have interpreted the data in another way, identifying a different set of codes or themes. Finally, most articles considered in the study were framed within the American experience, meaning that our findings might not be generalizable to other cultural or mental health contexts.

Implications

Despite the increased attention to multiculturalism and diversity issues in counseling research, there is limited scholarship that centers on immigrant children (Ceballos et al., 2023; Zyromski et al., 2023). This knowledge gap is concerning given the rapid growth of immigrant children populations in the United States and the well-documented deterioration of mental health and well-being that many immigrant adolescents experience upon arrival in their host country (Sirin et al., 2013).

While limited in number, existing literature has pointed to the multilevel needs and challenges facing most immigrant-origin youth. As evidenced in theme three (Adjustment) and four (Mental Health Needs), immigrant children often confront a complex set of adaptation and mental health challenges stemming from multiple levels of contexts, including the individual, interpersonal, family, school, community, and systemic level. Given that these challenges can result in developmental and mental health risks in children that are compounded by the presence of contextual adversity (i.e., immigrant status) (Gonzales et al., 2013; Gyan et al., 2023; Ibáñez-Alfonso et al. 2021), it is imperative for practitioners and school staff who work with immigrant children and families to be aware of their unique and multifaceted needs. Mental health professionals should take into consideration, but not limited to, acculturative stress, intergenerational conflicts, migration-related trauma, fear of deportation and immigration raids, bullying, discrimination, and oppression related to immigrant status. With increased awareness of differential challenges on the individual, interactional, and systemic levels, practitioners must better understand the universal and everyday struggles experienced by many immigrant children and families while examining the individual and group variations in child adaptation within their ecological environments.

Indeed, articles included in this analysis have made multiple calls for multicultural awareness and competence in counseling among professionals working with immigrant and refugee children and families (Theme 5). As such, providing training opportunities for school personnel and other critical professionals may benefit immigrant children and families in community and school-based contexts, as professionals seek to maintain a sensitivity to the relevant issues and within-group differences. To promote holistic wellness and optimal functioning, these training programs or activities may also seek to inform various practitioners of relevant organizations and area resources that can provide support to immigrant children and their families. These resources may include linkages to community-based organizations that offer services such as language classes, legal assistance, employment support, housing, social services, and parent education.

In light of the well-documented mental health disparities among immigrant children, this analysis also put forth the need for integrating psychosocial services in schools, which may include a range of services based on immigrant students’ universal and circumstantial needs, such as career guidance, support groups, and other school-based interventions. Prior researchers suggested school-based mental health services as an effective way to combat barriers to care utilization among young individuals, as many adolescents are more likely to receive care in the context of schools than outpatient specialty mental health care (Bear et al., 2014). As such, our findings added evidence for the integral role of schools in promoting healthy adaptation and development of immigrant children, potentially bridging the long-existing disparities in immigrant communities.

Lastly, the counseling profession calls for advocacy for the mental health and social needs of members of the community, especially those who are continuously marginalized due to structural imbalances (Stewart, 2014). As children and families continue to enter the United States through immigration and to seek asylum, it is necessary for clinical mental health counselors, school counselors, and counselor educators to identify mental health needs, examine best practices and evidenced-based and culturally inclusive services, and advocate for mental health care and systemic support of this growing population. School counselors specifically can continue to advocate for immigrant children’s development and mental health needs through their work within the school system. They can partner with counselors within multiple contexts outside the school to provide the mental health support necessary to support children’s social, emotional, and subsequently academic and career development that arise from social inequities (Edirmanasinghe et al., 2022). Counselor educators must also join this call by partnering with counselors engaging in this work within the field to enhance the research base and advance counselors’ understanding of the needs of immigrant children, promote best practices, and develop modalities to ensure culturally competent services for immigrant children and families (Crawford et al., 2019).

Future research

The analysis of immigrant children literature shows that nearly 50% of the articles adopted conceptual research traditions, while no studies using mixed-methods analysis were found to explore issues relevant to immigrant children and families. Conceptual frameworks are valuable in providing a theoretical foundation for conceptualizing and guiding the actions needed for best practices. However, empirical studies examining evidence-based strategies that are culturally responsive to immigrant children are largely needed. Specifically, the interventions discussed in theme two were predominantly conceptual or theoretical in nature. As such, more empirical inquiries are warranted to inform developmentally, and ecologically focused preventative and treatment interventions delivered in various contexts that can bring about positive changes in real-world settings. This research will help examine the efficacy of various approaches and facilitate the development of strategies to adapt and optimize existing evidence-based interventions for immigrant children and families.

Further, investigators may also consider gather data from various sources such as providers, service users, family members, community personnel, or policy makers. Collecting triangulated data from a variety of perspectives is indeed essential when conducting cross-cultural research with populations from diverse backgrounds (Suárez‐Orozco & Carhill, 2008). To reduce mental health disparities among immigrant children, research developing and testing service delivery strategies is critical for promoting access, treatment quality, feasibility, effectiveness, and continuity of mental health services for children, adolescents, and family members from immigrant communities.

To meet the diverse and complex needs of immigrant children in different system levels of context, researchers should also take into account multiple levels of analysis. Indeed, adjustment and mental health among immigrant children were shown as complex and nuanced processes involving multiple interconnected contextual factors. Understanding these intricate phenomena requires a multi-pronged approach which utilizes multiple lenses. As such, researchers may consider employing mixed methods research approaches to quantitatively examine intervention efficacy while qualitatively unearthing the lived experience, context, and process of service delivery and implementation. This approach may enable researchers to answer a more comprehensive range of questions about issues relevant to immigrant children, while adding critical insight and comprehension that might not be achieved by using only a single methodology.

While researchers attempted to delineate the differential needs, risks, and strengths in different groups between first- and second-generation immigrant children, most studies in counseling do not differentiate mental health, adjustment, and development outcomes between first- and second-generation children from immigrant families. Further, many articles are limited in accounting for factors such as immigrant generation, age of immigration, country of origin, or duration as an immigrant. Given the growing evidence on the differential health patterns and outcomes observed according to children’s immigration generation (Arora et al., 2021), it is imperative for scholars to recognize and attempt to explain the heterogenous and context-dependent psychosocial and cultural impact among immigrant children over two generations.

Our findings also illuminated the current strength of counseling literature on immigrant children, demonstrating through the analysis of highly specific and disaggregated racial/ethnic groups, such as Korean immigrant youth, Latino immigrant children, African refugee youth, and Turkish immigrant adolescents. Given that the ethnic composition of immigrant populations today becomes increasingly heterogeneous (Hooker et al., 2019), future research should continue to systemically examine racial and ethnic variations in immigrant children health by collecting disaggregating health data among adolescents and families from heterogeneous cultural groups. These analyses can have significant policy implications that guide the allocation of resources to individuals who need them the most, ultimately reducing mental health disparities over time.

However, it is important to note that the predominant focus on singular form of identity also appeared to overlook the intersectional and multifaceted nature of immigration and health-related challenges that immigrant children and families encounter. As such, future research agenda should consider incorporating intersectionality theory as a guiding or facilitating framework that accounts for the complex interplay and impact of immigration status and other social locations on development and health outcomes. By expanding upon the existing acculturation-based paradigm that primarily centers on individual-level cultural changes, the integration of intersectionality may advance the immigrant literature. This future research can lead to a focus on structural examinations that consider the power dynamics of race, class, gender, and immigrant status hierarchies and how they contribute to structural inequalities as well as health disparities.

Conclusion

Despite the noticeable increase in attention to multiculturalism, diversity issues, and social justice advocacy in counseling research, the specific focus on immigrant children remains limited. Our content analysis revealed significant gaps in the existing literature, including a lack of studies dedicated to addressing the unique issues facing immigrant children and adolescents, as well as multiple methodological and conceptual concerns. The emergent themes from the analysis provided insights into the unique needs and challenges facing immigrant children, including issues related to racial and ethnic identity, intervention, adjustment, mental health, and multicultural competence. The researchers provided implications for both best counseling practices and future research, hoping to illuminate the areas where further investigation and practice development are critical for promoting more culturally inclusive and competent practices that prioritize the mental health and holistic wellness of immigrant children.

Citation diversity statement

In this work, we acknowledge the fundamental importance of embracing diversity in scholarly endeavors. We recognize that our sources and references play a crucial role in shaping the perspectives and voices represented in our research. Our commitment is to foster inclusivity, celebrate a variety of viewpoints, and contribute to a more comprehensive understanding of the diverse topic of examining refugee children and adolescents in the counseling literature.

That said, we have made every effort to include a diverse range of sources, and acknowledge that there may be limitations in achieving full representation of all voices. We aim to actively seek out and cite works encompassing a spectrum of backgrounds, experiences, and perspectives. We are mindful of the potential biases that can arise from citation practices and are dedicated to challenging these biases by highlighting underrepresented voices and narratives.

Disclosure statement

No potential conflict of interest was reported by the author(s).